Snail Mail and Money Order Form
Please print out the form below and mail it with your $24.95 membership fee to:
Smart-list.com
P.O. Box 1361
Dubuque, Iowa 52004-1361
(Please skip the credit card section if you will be sending a check or money order.)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
You can also pay by credit card by filling out the following (please print clearly):
Credti Card Number:____________________
Card Expiration Date:_______________
Name on Card:___________________
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Your full name:______________________
Your primary e-mail address:________________
E-mail address to include on Smart-list:_______________
*Membership fee for the first year is $24.95 for one or
both lists.
The Smart-list website that you had been referred to
(will be something like www.smart-list.com/members/yoursponsorsname)
You must fill out this field so that your sponsor will
receive the credit for your sign-up:_____________________
If you were not referred to Smart-list by a sponsor,
please let us know how you found us:_bbprld_________
-------------------------------------------------------
You will receive a username and password to access Smart-list immediatly after your payment is received
and processed.